In the days leading up to the Saturday deadline to enroll for 2019 coverage under the Affordable Care Act, former president Barack Obama said he was hopeful that he wouldn’t need to shoot jump shots or hang out with comedian Zach Galifianakis to convince people to sign up this year, even with fewer people choosing a plan on Healthcare.gov.
But Obama's optimism about the ACA during the Trump administration would be challenged when a federal judge in Texas ruled the entire law unconstitutional on Friday night. U.S. District Judge Reed O'Connor's ruling on a lawsuit filed by a coalition of Republican state officials has the potential to cause massive disruption across the health-care system if the opinion stands, The Washington Post's Amy Goldstein reported.
Obama responded on Saturday by saying in a Facebook post that "Republicans will never stop trying to undo" the health-care law and urging people to continue to get covered under the ACA as the decision makes its way through the courts in what could be a prolonged appeals process. As of early Monday, his Facebook post has received more than 28,000 reactions, and has been liked more than 72,000 times since he also shared it on Twitter.
The former president tried to quell any dread that the ruling could ultimately strike down the entirety of his signature health-care law, which is commonly referred to as Obamacare.
"[Y]ou might have heard about a federal court decision on a Republican lawsuit trying to strike down the Affordable Care Act in its entirety," Obama wrote in a Facebook post on Saturday. "That can be a scary thing to hear, particularly if you or someone you care about has a preexisting condition. And that's why it's so important for you to know that last night's ruling changes nothing for now. As this decision makes its way through the courts, which will take months, if not years, the law remains in place and will likely stay that way."
Later, Obama highlighted what he calls the strengths of the legislation — young people staying on their parents' plans until they're 26, the coverage of preventive mental, preventative and contraceptive care, and women not being charged more for the same services.
No talking point, however, got more attention from Obama than the ACA's protections for people with preexisting conditions. Without the ACA, 52 million Americans under 65 could see their insurance at risk due to a preexisting condition, according to a 2016 analysis from the Kaiser Family Foundation. The Post's Sean Sullivan noted how Trump and Republican candidates vowed during the midterms to save protections for preexisting conditions, even though Trump's administration also embraced the January lawsuit from GOP attorneys general and governors. This wasn't lost on Obama, who mentioned preexisting conditions three times in his post.
"But all of this should also be a reminder that Republicans will never stop trying to undo all that," Obama wrote. "If they can't get it done in Congress, they'll keep trying in the courts, even when it puts people's preexisting conditions coverage at risk."
A Friday statement from the White House on the ruling said that it expects the decision to be "appealed to the Supreme Court." "Pending the appeal process, the law remains in place," the White House said.
But Obama’s successor took a less measured approach to the ruling. President Trump took to Twitter on Friday night to boast how O’Connor’s opinion found the ACA to be “an UNCONSTITUTIONAL disaster,” while calling on Congress to “pass a STRONG law that provides GREAT healthcare and protects preexisting conditions.”
"Wow, but not surprisingly, ObamaCare was just ruled UNCONSTITUTIONAL by a highly respected judge in Texas," Trump said in a follow-up tweet. "Great news for America!"
O'Connor's sweeping ruling could strike down every aspect of the ACA, including the individual mandate, Medicaid expansion and protections for preexisting conditions. A spokeswoman for California Democratic Attorney General Xavier Becerra told Goldstein that the ruling could be challenged in the U.S. Court of Appeals for the 5th Circuit, while Sen. Susan Collins, R-Maine, called the ruling "far too sweeping," telling CNN on Sunday that it would be "overturned on appeal." But White House adviser Stephen Miller suggested otherwise, telling CBS's "Face The Nation" that the Trump administration believes the law will be appealed to the Supreme Court, where it will be ruled unconstitutional.
Regardless of the legal fight ahead, Obama argued that the voting momentum from last month's midterms that helped Democrats recapture the House of Representatives needed to be sustained for anyone hoping to stop GOP efforts to repeal the ACA.
"The only way to convince them to stop trying to repeal this law, and start working to make health care better, is to keep voting, in big numbers, in every election, for people who'll protect and improve our care," Obama said.
The Post's Colby Itkowitz explained that the timing of the ruling comes as public opinion on the ACA has shifted toward the Democrats. Americans have been more favorable than unfavorable toward the ACA for nearly two years, according to research conducted by KFF. A KFF poll last month found that 65 percent of Americans think it's "very important" to prohibit insurers from denying coverage based on a person's medical history. Ahead of the midterms, nearly 60 percent of likely voters said they wanted to keep the ACA, according to a Reuters/Ipsos poll in late October.
The response to Obama's sentiments about the ruling elicited a mostly positive response on his Facebook and Twitter accounts.
One Facebook user, Christina Kicak, spoke of how the ACA has helped her 9-year-old daughter, who she said has Type 1 diabetes. "She did nothing to deserve this terrible illness and because of you she currently can not be denied health coverage," she wrote.
Another woman spoke of how her 27-year-old son had been without insurance for a year before enrolling Saturday. "He said, 'Mom it was so easy and I feel like a heaven weight has been lifted off my shoulders,'" Crystal Abeyta wrote.
Other users also wanted to poke fun at Trump and his vision for health care. "I don't want 'trumpcare,'" Cris Egle wrote. "I want Obamacare! because I know Obama really does care."
Conservative and right-leaning users, though, derided Obama's response. "LOL....Him trying hard isn't he?" wrote Newsmax personality Wayne Dupree.
About halfway through his post, Obama reiterated his argument that getting enrolled in the ACA is "a good way to show that you're tired of people trying to take away your health care."
“A lot of good people are fighting to ensure that nothing about your care will change,” Obama wrote. He later concluded: “All of that is guaranteed by the ACA as long as it’s the law.”